Imaging of Multiple Myeloma

Abstract

Background Multiple myeloma is a malignant hematological disease characterized by uncontrolled proliferation of monoclonal plasma cells mainly in the bone marrow. Imaging plays a crucial role in diagnosis and follow-up.

Method This literature review provides information about multiple myeloma, its precursor diseases, and available imaging techniques. Advantages and limitations as well as possible prognostic and therapeutic implications of the different imaging methods are presented in the context of the current literature.

Results and Conclusion Cross-sectional imaging has replaced conventional X-ray skeletal survey. Widely available whole-body computed tomography is routinely used to detect osteolytic lesions. Magnetic resonance imaging is the most sensitive technique to identify bone marrow infiltration and is recommended in multiple myeloma precursor diseases. Positron emission computed tomography combines morphological and functional imaging. It is mainly used for follow-up, therapy monitoring, and response evaluation.

Key points: 

• Conventional X-ray skeletal survey is obsolete.

• Whole-body CT is routinely used to detect osteolysis.

• MRI is the most sensitive modality to identify bone marrow infiltration.

• MRI is used for the workup of precursor diseases (alternatively: PET/CT).

• PET/CT is used for follow-up, therapy monitoring, and response evaluation.

Citation Format

• Kosmala A, Bley T, Petritsch B. Imaging of Multiple Myeloma. Fortschr Röntgenstr 2019; 191: 805 – 816

Key words

myeloma - MGUS - smouldering multiple myeloma - whole-body magnetic resonance imaging (WBMRI) - whole-body low-dose computed tomography (WBLDCT) - PET-CT

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